Behavioral Mental Health Registered Nurse (RN) Case Manager

Children's Healthcare of AtlantaAtlanta, GA
69d

About The Position

Provides clinically and evidence-based patient care coordination for patients with behavioral and mental health (BMH) needs. Supports delivery of safe, effective, high-quality, and efficient patient care at Children’s Healthcare of Atlanta. Coordinates assessment, interdisciplinary discharge planning, and coordination of community-based services to assigned patients discharged from a Children's Healthcare of Atlanta facility.

Requirements

  • 3 years RN experience with a Bachelor of Science in Nursing (BSN) OR Current Children’s RN with 5 years of experience with an Associate’s degree in nursing (Current Children’s nurse with an associate’s degree in nursing is required to obtain a BSN within 2.5 years of hire date
  • 3 years of broad clinical experience, predominantly in pediatric and/or behavioral and mental health care
  • Graduation from an accredited school of nursing
  • Licensure as a Registered Nurse in the single State of Georgia or Multi-State through the Enhanced Nurse Licensure Compact
  • Basic Life Support (BLS) within 30 days of employment
  • Registered Nurse case management certification from approved accrediting organization within 1 year of meeting eligibility requirements
  • Excellent communication skills, both verbal and written
  • Effective decision making/problem-solving skills and demonstration of creativity in problem-solving
  • Influential leadership skills
  • Demonstrated effective critical thinking skills and ability to anticipate patient discharge needs
  • Moderate to expert computer skills
  • Working knowledge of financial aspects of third-party payors and reimbursement

Nice To Haves

  • Master's degree
  • Experience in care coordination, case management, discharge planning and/or utilization review

Responsibilities

  • Serves as a system clinical resource for Care Coordination Assistants during scheduled shift.
  • Completes initial screen of all patients on admission (not to exceed within 24 hours of admission) utilizing specific trigger criteria to identify needs related to care coordination and/or discharge planning.
  • Develops, initiates, and implements a robust transition care plan in collaboration with clinical team for all applicable patients.
  • Cultivates and maintains effective interaction/communication with providers, nursing staff, social workers/counselors and others to drive care coordination process and facilitate continuity of patient care.
  • Communicates with all members of multidisciplinary team to facilitate care coordination process for assigned workload.
  • Oversees psychiatric residential treatment facility (PRTF) referral process, documentation, and submission, as necessary.
  • Communicates with home health agencies, third-party payors, acute and long-term psychiatric facilities, and other community resources as needed to coordinate discharge needs.
  • Ensures information sharing with Community Care Navigators regarding any BMH patients who require PRTF, meet high-utilizer criteria, or are identified as complex.
  • Facilitates and provides ongoing communication with patient/family and interdisciplinary staff to identify, escalate, and resolve potential barriers.
  • Facilitates care conferences, interdisciplinary rounds, and other meetings.
  • Serves as the clinical tiered support for EMS transport needs and escalations.
  • Completes medication prior authorizations and prescription arrangements, as necessary.
  • Participates in focused system initiatives and facilitates clinical practice guidelines at the patient level.
  • Performs outpatient and clinic care coordination and monitors care as patients transition between outpatient and inpatient services where appropriate.
  • Refers cases identified as risk management, peer review, or quality issues to appropriate personnel.
  • Performs other responsibilities as required.

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What This Job Offers

Job Type

Full-time

Career Level

Mid Level

Education Level

Associate degree

Number of Employees

5,001-10,000 employees

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